Nephritic/nephrotic/vasculitis

Question 1

Lower respiratory tract symptoms, eosinophlia

Answer 1

Eosinophilic granulomatosis with polyangiitis (Churg-Strauss)

Question 2

Nephritic + Pulmonary haemorrhages, haemoptysis

Answer 2

Goodpasture’s

Question 3

Nephritic + sinusitis, vasculitic rash, epistaxis

Answer 3

Granulomatosis with polyangiitis

Question 4

Nephrotic or nephritic? Membranous glomerulonephritis

Answer 4

Nephrotic

Question 5

Causes of Membranous glomerulonephritis

Answer 5

Malignancy, NSAIDs, gold, SLE, rheumatoid, anti-phospholipase A2 antibodies

Question 6

Management of Membranous glomerulonephritis

Answer 6

ACE-i or ARB, immunosuppression if severe. 1/3 spontaneous remission, 1/3 proteinuric, 1/3 ESRF

Question 7

Nephrotic or nephritic? Rapidly progressive glomerulonephritis

Answer 7

Nephritic

Question 8

Nephrotic or nephritic? IgA nephropathy

Answer 8

Nephritic

Question 9

Nephrotic or nephritic? Alport syndrome

Answer 9

Nephritic

Question 10

Nephrotic or nephritic? Minimal change disease

Answer 10

Nephrotic

Question 11

Nephrotic or nephritic? Focal segmental glomerulosclerosis

Answer 11

Nephrotic

Question 12

Nephrotic or nephritic? Amyloidosis

Answer 12

Nephrotic

Question 13

Nephrotic or nephritic? Diabetic nephropathy

Answer 13

Nephrotic

Question 14

Nephrotic or nephritic? Diffuse proliferative glomerulonephritis

Answer 14

Mixed

Question 15

Nephrotic or nephritic? Membranoproliferative glomerulonephritis (mesangiocapillary)

Answer 15

Mixed

Question 16

Nephrotic + child + steroid responsive + Hodgkin’s/NSAIDs

Answer 16

Minimal change disease

Question 17

Nephrotic + infection/rheumatoid/malignancy

Answer 17

Membranous glomerulonephritis

Question 18

Nephrotic + HIV/heroin

Answer 18

Focal segmental glomerulosclerosis

Question 19

Nephritic + young person + recent URTI (days)

Answer 19

IgA nephropathy

Question 20

Nephritic + child + recent strep (weeks)

Answer 20

Diffuse proliferative (post-streptococcal)

Question 21

Causes of focal segmental glomerulosclerosis

Answer 21

Reflux nephropathy, IgA nephropathy, HIV, heroin, sickle cell

Question 22

Child + microscopic haematuria + renal failure + b/l sensorineural deafness

Answer 22

Alport’s - X-linked, type 4 collagen

Question 23

Renal biopsy - basket weave

Answer 23

Alport’s (splitting of lamina densa)

Question 24

Congo red stain - apple-green birefringence

Answer 24

Amyloidosis

Question 25

Glomerulonephritis + low complement

Answer 25

Post-streptococcal, bacterial endocarditis, SLE, mesangiocapillary glomerulonephritis

Question 26

Membranoproliferative (mesangiocapillary) glomerulonephritis causes

Answer 26

Type 1 - cryoglobulinaemia, Hep C (tram-track), type 2 partial lipodystrophy (dense deposits, low C3)

Question 27

Renal biopsy - spike and dome

Answer 27

Membranous glomerulonephritis

Question 28

Renal biopsy - normal glomeruli, fusion of podocytes and effacement of foot processes

Answer 28

Minimal change disease

Question 29

Renal biopsy - starry sky on immunofluorescence

Answer 29

Post-streptococcal (Enlarged and hypercellular glomeruli)

Question 30

Hypokalaemia, hypertension, AD

Answer 30

Liddle syndrome

Question 31

Liddle syndrome

Answer 31

Hypertension. Increased Na reabsorption.

Question 32

Hypokalaemia, normal BP, low Mg

Answer 32

Gitelman

Question 33

Bartter

Answer 33

NKCC defect. HypoK, normal BP

Question 34

Most common lupus nephritis

Answer 34

diffuse proliferative glomerulonephritis, also most severe

Question 35

Renal biopsy wire-loop appearance

Answer 35

diffuse proliferative glomerulonephritis

Question 36

Renal biopsy nodular glomerulosclerosis

Answer 36

Diabetic nephropathy (Kimmelstiel-Wilson lesions)

Question 37

Renal biopsy - mesangial hypercellularity

Answer 37

IgA nephropathy